Minnesota Hospital Tosses Pharma Freebies

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As part of a new policy that experts say is one of the toughest in the nation blocking drugmakers from influencing docs, SMDC Health System in Duluth, Minnesota, recently got rid of nearly every freebie with a drug company name on it, The Minneapolis Star-Tribune reports.

“We’re part of a leading trend that’s trying to get away from the pharmaceutical companies essentially controlling what’s prescribed in this country,� Ken Irons, chief of community clinics for SMDC, tells the paper. “This shows people we’re not in the pharmaceutical companies’ back pockets.�

In all, SMDC employees have turned in more than 18,700 items, including clocks, mugs, surgical caps, calculators, tape dispensers, and a stress-relieving squeeze toy made to look like a red blood cell. Administrators plan to donate the 20 shopping carts full of stuff to a hospital in Cameroon, where supplies of all types are desperately needed – and most of the advertised drugs aren’t available.

Abolishing all logos from their facilities marks the latest and most drastic in a series of steps many of Minnesota’s top health care institutions have taken in recent years to limit the doctor-drug rep relationship, including bans on the catered free lunches and schmooze sessions that were once a daily occurrence in most hospitals and clinics.

But can a doctor pulling down $150,000 a year really be bought for a femur-shaped plastic pen with “Zometa� printed on it?

“If you’d have asked me 10 years ago, I’d have said no,� Irons says. “But what a lot of studies are showing is that even simple little things like pens or pencils help (prescriptions for) those drugs get written.�

He adds that said about 70 of the region’s drug reps attended a meeting where they heard details of the new policy and voiced no major objections. Board members of the Arrowhead Pharmaceutical Representative Association did not answer requests for interviews.

However, an industry spokesman says SMDC’s policy is unprecedented and unnecessarily harsh. “This is the first time I’ve ever heard of a systematic round-up of pens,� said Ken Johnson, senior vp at PhRMA. “Clearly there’s a marketing backlash we’ve seen in a number of states. But this is a bit draconian.� He adds that reps and marketing materials are often sources of important drug information for doctors. Cutting off that access could be detrimental to patients.

That’s doubtful, according to Jeff Adams, an SMDC emergency room physician and a professor at the University of Minnesota Duluth medical school. Adams was among the group’s doctors who pushed for the new policy. In addition to removing everything with a logo, the policy places strict limits on where and how doctors and reps can interact, and what doctors can accept from them.

“Drug reps are very nice people, but the information they have tends to be biased,� says Adams, adding that better sources such as peer-reviewed journals and pharmacists are readily available. More doc are coming to see that free lunches, and even trinkets, may not be harmless either. “The drug companies aren’t stupid,� he tells the paper. “They don’t give you pens for no reason. When you have ‘Azithromycin’ on your stethoscope, you’re like the car driving down the street advertising Pizza Hut.�

Drugmakers can still participate in educating SMDC docs and patients, but they must route materials and messages through the group’s education specialists, which limits direct contact and gives them the opportunity to check info against other sources.

Irons acknowledges that the new policy will cost SMDC. He said that refusing to let drug companies sponsor educational conferences and display their materials at them will mean a loss of at least $100,000 a year. And the office supply bill will rise when pens say SMDC rather than Abraxane or Trasylol.

But such policies should actually reduce costs to patients and their insurers, according to Sidney Wolfe at Public Citizen, a nonprofit consumer advocacy group in Washington. “A hundred thousand a year is nickels and dimes compared to the savings patients will experience when they aren’t prescribed the most expensive drugs inappropriately,� Wolfe tells the paper. “All this stuff that’s handed out is really influence peddling. It’s legalized bribery.�
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